The case for tobacco packaging restrictions goes up in smoke

Friday, 18 May 2018In 2016 and 2017, two significant pieces of tobacco control legislation came into effect in the UK and France.

One was the EU’s Second Tobacco Control Directive (TPD2), which applied across the EU. The other was standardised packaging requirements, introduced only in individual countries, with the UK and France being the first.

As well as various other measures, such as restrictions on the advertising of electronic cigarettes and other vaping devices, TPD2 introduced a series of additional restrictions on the packaging of tobacco products.

These included: making 20 the minimum number of cigarettes per pack, and 30 grams the minimum weight for roll-your-own tobacco packs; updating health warnings and requiring them to cover 65 per cent of the front and back of tobacco products; and banning certain descriptors on packaging (such as “natural” and “organic”).

At around the same time, France and the UK adopted additional measures imposing standardised packaging of tobacco products (“plain packs”).

These involve precise restrictions such as: the banning of all branding with the exception of the name, which has to appear in a standardised font and size; the required material, size, shape and opening mechanism of packaging; and the font, colour, size, case and alignment of text on packs.

Those advocating these measures argued that they would lead to reductions in tobacco prevalence (the proportion of people that smoke) and consumption (how many cigarettes are smoked per day).

The UK government produced an impact assessment for TPD2 in 2015. This forecast a reduction of 1.9 per cent in both prevalence and consumption over five years, equivalent to 0.08 percentage points reduction in prevalence in the first year (2016) if prevalence would have been 19.7 per cent.

My colleagues and I at Europe Economics were commissioned by tobacco company JTI to assess any impacts yet discernible from TPD2 and plain packs upon tobacco consumption in France and the UK, and smoking prevalence in the UK. We did this using three very standard statistical models, which economists call “simple linear trend models”, “time series models”, and “simultaneous equations models”.

A “simple trend model” considers whether the prior trend in tobacco consumption or prevalence was changed at the time regulation came into force (e.g. if tobacco prevalence was falling, did it start falling faster after the measure was introduced?).

A “time series model” makes the simple trend model more sophisticated by considering the possibility that the prior evolution was more complex than simply a trend, possibly reflecting lags (any disturbance to the trend taking a while to wear off), seasonal effects (e.g. Christmas, summer), and moving averages, and also taking account of prices.

A “simultaneous equations model” allows for the possibility that TPD2 and plain packs requirements might have their effects on prevalence or consumption either directly or via an impact on prices, which in turn affected consumption or prevalence (so, for example, even if TPD2 had had no direct impact on consumption, if it raised prices and higher prices meant lower consumption, there would still have been an indirect effect).

These models may sound a bit complicated, but our results are very straightforward. We have found no impact. No impacts on prevalence in the UK. No impacts on consumption in the UK or in France.

Statistical models of this sort cannot tell us whether TPD2 and standardised packaging will or will not have some impact on prevalence or consumption over the longer term. But impacts of these measures were expected by this point, and the data do not show them.

For such a major set of measures, this is a striking result.

It appears to suggest that the factors that explain why tobacco prevalence and consumption have been falling in recent decades and the contribution of tobacco control measures to that may have been misunderstood. That could and should have implications for future policy-making in this area.

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